Individual
JAIME L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 MEDICAL PARK BLVD STE 458W, BRISTOL, TN 37620-7456
(423) 844-4800
(423) 230-6905
Mailing address
105 W STONE DR STE 6A, KINGSPORT, TN 37660-3256
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001204968
VA
363LF0000X
Family Nurse Practitioner
Primary
23066
TN
Other
Enumeration date
06/21/2017
Last updated
08/21/2017
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